Homozygous familial hypercholesterolemia. Selective removal of low- density lipoproteins by secondary membrane filtration

Selective plasma filtration with a hollow-fiber membrane device was compared prospectively to plasma exchange in the therapy of a patient with homozygous familial hypercholesterolemia. Four liters of patient plasma was removed biweekly during each of six consecutive plasma exchanges, after which 20 consecutive biweekly 4-liter filtration procedures were conducted. The hollow-fiber membrane retained 94 percent of the low-density lipoprotein (LDL) cholesterol presented to it, and allowed passage of 83 percent of the albumin, 68 percent of the IgG, and 47 percent of the high-density lipoprotein (HDL) cholesterol. Both plasma exchange and plasma filtration decreased the patient's total and LDL cholesterol levels by 80 percent. However, filtration removed significantly less HDL than did exchange (54 versus 71% reduction in HDL levels, respectively); preserved significantly higher levels of IgG, clotting factors, and complement components; and avoided the need for expensive albumin replacement solutions. In addition, the patient tolerated the filtration procedures significantly better than the exchanges. Newer apheresis techniques that selectively deplete plasma of LDL cholesterol, such as secondary membrane filtration, are likely to replace plasma exchange as the therapy of choice in patients with homozygous hypercholesterolemia.     

Long-term treatment of lupus nephritis with cyclosporin A

We evaluated the efficacy and safety of long-term treatment with cyclosporin A (CSA) in type IV lupus nephritis. Seventeen patients with biopsy-proven WHO type IV lupus nephritis were enrolled in a prospective, open study. Twelve of the 17 completed 48 months of treatment with CSA and prednisolone. Three patients required the addition of azathioprine, at 12, 38 and 47 months, respectively, for cutaneous disease flare with refractory rashes. One patient was lost to follow-up at 40 months. The mean +/- SD duration of treatment was 43.2 +/- 10.1 months (range 15.7-48 months). A significant reduction of proteinuria and a significant rise in serum albumin were noted 1 month after initiation of treatment. Improvement was maintained throughout the study except for three patients who relapsed with recurrence of nephrotic syndrome. There were no significant changes in serum creatinine level or creatinine clearances throughout the study. Repeat renal biopsy at 12 months following treatment with CSA showed histological improvement, with WHO type II changes in all 17 patients accompanying significant reduction in activity indices. Patients with baseline haemoglobin (Hgb) levels < 12 g/dl showed significant improvement. Serum C3 and C4 levels were not changed significantly. Corticosteroid-sparing effects were noted. Side-effects included hypertension, gum hypertrophy and mild hirsuitism, but were not serious. Combination therapy using CSA and prednisone is effective and safe for long-term treatment in lupus patients with WHO type IV nephritis.      

Detection of cytomegalovirus antibody in platelet concentrates by fluorescence immunoassay and latex agglutination

A passive latex agglutination (PLA) test for cytomegalovirus (CMV) antibody detection has been shown to be an acceptable method of screening both donor sera and plasma from units of red cells and platelets stored in CPDA-1. However, most plateletpheresis concentrates are collected in ACD, and CMV antibody testing of ACD-stored products has not been systematically evaluated by PLA. Sera and ACD-stored platelet concentrate bag segments from 104 donors were tested by PLA and by a solid-phase fluorescence immunoassay (FIAX) as a reference standard for CMV-IgM and CMV-IgG antibodies. Sera were stored at both 4 and 22 degrees C and were tested on Days 1 and 5 of storage; segments were tested daily for 5 days. Of 63 donor samples (61%) that tested negative for CMV-IgG by FIAX, there were two false-positive results in bag segments by PLA testing, one on Day 1 and the other on Day 2 of storage. PLA testing was consistently positive in sera and segments in the 40 donors (38%) who tested positive for CMV-IgG by FIAX. Potential false-negative PLA results occurred in five bag segments derived from one donor whose serum gave equivocal CMV-IgG results on FIAX. The sensitivity and specificity of the PLA assay were 100 percent for donor sera tested at both 4 and 22 degrees C and 91.5 and 98.4 percent, respectively, for platelet bag segment tests. Although no donors positive for CMV-IgM were identified, 15 (14.4%) had equivocal IgM anti-CMV test results.(ABSTRACT TRUNCATED AT 250 WORDS)     

MHC antigen induction by interferon gamma on cultured mouse pancreatic beta cells and macrophages. Genetic analysis of strain differences and discovery of an "occult" class I-like antigen in NOD/Lt mice

This study provides a basis for understanding the wide variations reported in the literature in IFN-gamma inducibility of class II MHC antigens on murine beta cells. Inducibility is not an intrinsic property of all mouse beta cells, but instead depends upon strain- (and tissue-) specific response modifying factors. This was demonstrated by comparison of constitutive and IFN-gamma-induced class I and class II MHC gene products on cultured islet cell monolayers. Islet cultures were established from autoimmune diabetes-prone NOD/Lt mice, diabetes-resistant NON/Lt and CBA/J mice, as well as F1 hybrids between these latter two strains and NOD/Lt. Cultures of peritoneal macrophages (M phi) from each strain were established as controls. After 3 wk of culture (with incubation in the presence or absence of IFN-gamma during the last 6 d), constitutive expression as well as IFN-gamma induction of class I MHC antigen expression was demonstrated on NOD/Lt and NON/Lt islet cells by antibody plus complement-mediated cytotoxicity. Although CBA/J islets and M phi did not maintain constitutive class I or class II antigen expression in culture in the absence of IFN-gamma, class I H-2Kk antigen was IFN-gamma inducible. Whereas IFN-gamma-induced class II I-Ak antigen on CBA/J M phi, it failed to induce this antigen on CBA/J islets. In contrast, I-A antigens were IFN-gamma inducible on NOD/Lt and NON/Lt islets and M phi. In (CBA x NOD)F1 hybrids, loss of IFN-gamma inducibility of the I-ANOD product established that suppression was mediated by a trans-acting factor from the CBA/J genome. In the course of these studies, IFN-gamma inducibility of a crossreactive occult class I-like antigen on both NOD/Lt islet cell and M phi cultures was unexpectedly detected when mAb 28-13-3 (public specificity 39, reactive with H-2Kb,f) was used as a negative control. Although not detectable by cytofluorographic analysis of freshly isolated NOD/Lt splenic leukocytes, occult antigen could be induced on NOD/Lt peritoneal macrophages (M phi) cultured for 3 d in IFN-gamma. Time course of induction showed the occult antigen to be distinct from NOD/Lt class I and II gene products. In both islet cell and M phi cultures established from (CBA x NOD)F1 hybrids, trans-suppressive factor(s) from the CBA/J genome not only suppressed IFN-gamma-induced expression of I-ANOD, but additionally suppressed occult antigen induction. Backcross of F1 to both parental strains indicated that the occult locus was on Chr 17, tightly linked to MHC.(ABSTRACT TRUNCATED AT 400 WORDS)     

油酸多相脂质体(139)注射液包封率测定方法的研究

本文提出了油酸多相脂质体139注射液中脂质体的药物包封率和药物含量的测定方法,以凝胶过滤法Sephadex G-50柱测定139注射液中多相脂质体的重量包封率Qw平均为94.2%;同时又以显微镜照像及统计方法测量了脂质体的体积包封率Qv平均为97.1%。并讨论了影响脂质体中药物包封率的各种因素。     

木瓜及其伪品的紫外光谱聚类分析

目的 :鉴别木瓜及其伪品。方法 :采用紫外光谱聚类分析。结果 :不同种之间有不同距离而分不同的类别。结论 :初步判别木瓜的真伪优劣     

前胡伪品碎叶山芹的生药学研究

目的：对浙产前胡伪品碎叶山芹进行产地调查和鉴别。方法：采用生药学研究和理化分析法。结果：前胡及其伪品碎叶山芹的原植物形态、性状、显微特征及理化性质均有差异,可资鉴别真伪。结论：碎叶山芹不可作前胡药用。